Inhaled corticosteroids and the risk of pneumonia in people with asthma

Background In clinical trials, the use of inhaled corticosteroids is associated with an increased risk of pneumonia in people with COPD, but whether the same is true for people with asthma is not known. Methods With the use of primary care data from The Health Improvement Network, we identifi...

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Main Authors: McKeever, Tricia M., Harrison, Timothy W., Hubbard, Richard, Shaw, Dominick E.
Format: Article
Published: Elsevier 2013
Online Access:https://eprints.nottingham.ac.uk/38427/
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author McKeever, Tricia M.
Harrison, Timothy W.
Hubbard, Richard
Shaw, Dominick E.
author_facet McKeever, Tricia M.
Harrison, Timothy W.
Hubbard, Richard
Shaw, Dominick E.
author_sort McKeever, Tricia M.
building Nottingham Research Data Repository
collection Online Access
description Background In clinical trials, the use of inhaled corticosteroids is associated with an increased risk of pneumonia in people with COPD, but whether the same is true for people with asthma is not known. Methods With the use of primary care data from The Health Improvement Network, we identified people with asthma, and from this cohort, we identified patients with pneumonia or lower respiratory tract infection and age- and sex-matched control subjects. Conditional logistic regression was used to determine the association between the dose and type of inhaled corticosteroid and the risk of pneumonia or lower respiratory tract infection. Results A dose-response relationship was found between the strength of inhaled corticosteroid dose and risk of pneumonia or lower respiratory tract infection (P < .001 for trend) such that after adjusting for confounders, people receiving the highest strength of inhaled corticosteroid (≥ 1,000 μg) had a 2.04 (95% CI, 1.59-2.64) increased risk of pneumonia or lower respiratory tract infection compared with those with asthma who did not have a prescription for inhaled corticosteroids within the previous 90 days. Conclusions People with asthma receiving inhaled corticosteroids are at an increased risk of pneumonia or lower respiratory infection, with those receiving higher doses being at greater risk. Pneumonia should be considered as a possible side effect of inhaled corticosteroids, and the lowest possible dose of inhaled corticosteroids should be used in the management of asthma.
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spelling nottingham-384272020-05-04T20:18:27Z https://eprints.nottingham.ac.uk/38427/ Inhaled corticosteroids and the risk of pneumonia in people with asthma McKeever, Tricia M. Harrison, Timothy W. Hubbard, Richard Shaw, Dominick E. Background In clinical trials, the use of inhaled corticosteroids is associated with an increased risk of pneumonia in people with COPD, but whether the same is true for people with asthma is not known. Methods With the use of primary care data from The Health Improvement Network, we identified people with asthma, and from this cohort, we identified patients with pneumonia or lower respiratory tract infection and age- and sex-matched control subjects. Conditional logistic regression was used to determine the association between the dose and type of inhaled corticosteroid and the risk of pneumonia or lower respiratory tract infection. Results A dose-response relationship was found between the strength of inhaled corticosteroid dose and risk of pneumonia or lower respiratory tract infection (P < .001 for trend) such that after adjusting for confounders, people receiving the highest strength of inhaled corticosteroid (≥ 1,000 μg) had a 2.04 (95% CI, 1.59-2.64) increased risk of pneumonia or lower respiratory tract infection compared with those with asthma who did not have a prescription for inhaled corticosteroids within the previous 90 days. Conclusions People with asthma receiving inhaled corticosteroids are at an increased risk of pneumonia or lower respiratory infection, with those receiving higher doses being at greater risk. Pneumonia should be considered as a possible side effect of inhaled corticosteroids, and the lowest possible dose of inhaled corticosteroids should be used in the management of asthma. Elsevier 2013-12 Article PeerReviewed McKeever, Tricia M., Harrison, Timothy W., Hubbard, Richard and Shaw, Dominick E. (2013) Inhaled corticosteroids and the risk of pneumonia in people with asthma. Chest, 144 (6). pp. 1788-1794. ISSN 1931-3543 http://www.sciencedirect.com/science/article/pii/S001236921548688X doi:10.1378/chest.13-0871 doi:10.1378/chest.13-0871
spellingShingle McKeever, Tricia M.
Harrison, Timothy W.
Hubbard, Richard
Shaw, Dominick E.
Inhaled corticosteroids and the risk of pneumonia in people with asthma
title Inhaled corticosteroids and the risk of pneumonia in people with asthma
title_full Inhaled corticosteroids and the risk of pneumonia in people with asthma
title_fullStr Inhaled corticosteroids and the risk of pneumonia in people with asthma
title_full_unstemmed Inhaled corticosteroids and the risk of pneumonia in people with asthma
title_short Inhaled corticosteroids and the risk of pneumonia in people with asthma
title_sort inhaled corticosteroids and the risk of pneumonia in people with asthma
url https://eprints.nottingham.ac.uk/38427/
https://eprints.nottingham.ac.uk/38427/
https://eprints.nottingham.ac.uk/38427/